youth mission application SUMMER YOUTH MISSION 2026: TBADates: TBAPlease see the description and application below!!INFORMATION REGARDING THE 2026 MISSION TRIP IS COMING SOON. Name * First Name Last Name Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date of Birth * MM DD YYYY PARENT/GUARDIAN INFORMATION We require the contact information for at least one parent or guardian. Parent / Guardian Name * First Name Last Name Relationship to Student * (ie. Mother, Father, Guardian, etc.) Parent / Guardian Phone * Country (###) ### #### Secondary Phone Number * Country (###) ### #### Parent / Guardian Email * Second Parent / Guardian Name First Name Last Name Relationship to Student (ie. Mother, Father, Guardian, etc.) Parent / Guardian Phone Country (###) ### #### Parent / Guardian Email MEDICAL INFORMATION Health Card Number * Do you have any allergies? * Yes No If yes, please list your allergies: Do you have a history of any medical conditions or concerns? * Including but not limited to: Respiratory Problems, Fainting Spells, Asthma, Seizures, Diabetes, Heart Disease, Eating Disorders, Mental Health Concerns, Self-Harm, or Other Medical Concerns Yes No If yes, please outline them below: GENERAL INFORMATION Why do you want to join the youth mission trip this year? * What do you hope to grow in/learn on this mission? * Have you spoken to your parents about your involvement in this trip? * Yes No Do your parents support your participation in the youth mission trip? * Parental support/permission is required for participation in the youth mission. Yes No I still need to talk to them about it Do you have any additional comments or anything else you want us to know regarding your application? Thank you!
